Cardiac biomarkers in the prediction of risk in the non‐cardiac surgery setting

SummaryB‐Type natriuretic peptides and troponin measurements have potential in predicting risk in patients undergoing non‐cardiac surgery. Using the American Heart Association framework for the evaluation of novel biomarkers, we review the current evidence supporting the peri‐operative use of these two biomarkers. In patients having major non‐cardiac surgery who are risk stratified using clinical risk scores, the measurement of natriuretic peptides and troponin, both before and after surgery, significantly improves risk stratification. However, only pre‐ and postoperative natriuretic peptide measurement and postoperative troponin measurement have shown clinical utility. It is now important for trials to be conducted to determine whether integrating pre‐ and postoperative natriuretic peptide and postoperative troponin measurement into clinical practice is able to improve clinical outcomes in patients undergoing non‐cardiac surgery.